First-In-Human Phase I Study of a Next-Generation, Oral, TGFβ Receptor 1 Inhibitor, LY3200882, in Patients with Advanced Cancer.

Abstract

PURPOSE:

A novel, selective, next-generation transforming growth factor beta (TGFβ) receptor type-1 small molecule inhibitor, LY3200882, demonstrated promising preclinical data. This first-in-human trial evaluated safety, tolerability, recommended phase II dose (RP2D), pharmacokinetics, pharmacodynamics, and preliminary antitumor activity of LY3200882 as monotherapy or with other anticancer agents in patients with advanced cancer.

PATIENTS AND METHODS:

This phase I multicenter study of oral LY3200882 (NCT02937272) comprised dose escalation, monotherapy expansion in grade 4 glioma, and combination therapy in solid tumors (LY3200882 and PD-L1 inhibitor LY3300054), pancreatic cancer (LY3200882, gemcitabine, and nab-paclitaxel), and head and neck squamous cell cancer (LY3200882, cisplatin, and radiation).

RESULTS:

Overall, 139 patients with advanced cancer were treated. The majority (93.5%) of patients experienced ≥1 treatment-emergent adverse events (TEAE), with 39.6% LY3200882-related. Grade 3 LY3200882-related toxicities were only observed in combination therapy arms. One patient in the pancreatic cancer arm experienced cardiovascular toxicity. The LY3200882 monotherapy RP2Ds were established in two schedules: 50 mg twice a day 2-weeks-on/2-weeks-off and 35 mg twice a day 3-weeks-on/1-week-off. Four patients with grade 4 glioma had durable Revised Assessment in Neuro Oncology (RANO) partial responses (PR) with LY3200882 monotherapy (n = 3) or LY3200882-LY3300054 combination therapy (n = 1). In treatment-naïve patients with advanced pancreatic cancer, 6 of 12 patients achieved Response Evaluation Criteria in Solid Tumors (RECIST) v1.1 PR and 3 of 12 patients demonstrated stable disease, for an overall 75% disease-control rate with the combination of LY3200882, gemcitabine, and nab-paclitaxel.

CONCLUSIONS:

LY3200882 as monotherapy and combination therapy was safe and well tolerated with preliminary antitumor activity observed in pancreatic cancer. Further studies to evaluate the efficacy of LY3200882 with gemcitabine and nab-paclitaxel in advanced pancreatic cancer are warranted.

• Authors: Timothy A Yap, Maria Vieito, Capucine Baldini, Juan Manuel Sepúlveda-Sánchez, Shunsuke Kondo, Matteo Simonelli, Rasha Cosman, Andre van der Westhuizen, Victoria Atkinson, Antoine F Carpentier, Mario Löhr, Rebecca Redman, Warren Mason, Andres Cervantes, Emilie Le Rhun, Sebastian Ochsenreither, Louise Warren, Yumin Zhao, Sophie Callies, Shawn T Estrem, Michael Man, Leena Gandhi, Emin Avsar, Davide Melisi
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 27 Issue 24 Pg. 6666-6676 (12 15 2021) ISSN: 1557-3265 [Electronic] United States
• PMID: 34548321 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Comment)
• Copyright: ©2021 The Authors; Published by the American Association for Cancer Research.

Chemical References

• Antineoplastic Agents
• Transforming Growth Factor beta
• Paclitaxel

Topics

• Antineoplastic Agents (adverse effects)
• Antineoplastic Combined Chemotherapy Protocols (adverse effects)
• Head and Neck Neoplasms
• Humans
• Maximum Tolerated Dose
• Paclitaxel (therapeutic use)
• Pancreatic Neoplasms (drug therapy)
• Transforming Growth Factor beta